Tsiku lililonse, anthu pafupifupi 8 miliyoni ku United States (ambiri omwe ali ana ndi achinyamata) ali ndi ululu wopweteka kwa nthawi yoyamba m'miyoyo yawo.
Ngati izi zikuchitika kwa inu kapena munthu amene mumamukonda, muyenera kuchita chiyani? Kodi mukufunikiradi kuwona dokotala? Kodi muyenera kuyitanitsa bwanji kupuma kwachisoni? Ndipo ndi liti pamene mungafunike x-ray kapena MRIs?
Tiyeni tiwone zofunikira pa zomwe mungathe kuyembekezera kuchipatala kwa nthawi yoyamba yopweteketsa. Koma tisanafike ku izo, ndiroleni ndikupatseni uthenga wabwino. AHRQ, bungwe la zaumoyo la boma lomwe linati ndi "kupititsa patsogolo ubwino wathanzi," monga momwe adanenera pa webusaiti yawo, amalemba kuti kupwetekedwa kwapweteka kwambiri (komwe kumatanthauzidwa ngati chochitika chomwe chimatha kupitirira mwezi umodzi) nthawi zambiri amadzipangitsa okha. AHRQ imanena kuti kuthetsa kwathunthu kwa ululu, kulemala, kapena kuyendayenda pang'ono ndikusowa ntchito sikungatheke, komanso kuti anthu ambiri amatha msanga pambuyo pa choyambacho.
Kodi Muyenera Kudzera Dotolo?
Kudziwa zomwe AHRQ ikunena, kodi muyenera kupita kukaonana ndi dokotala mukakumana ndi ululu wammbuyo? Kawirikawiri, kupweteka kumbuyo sikuli koopsa, ndipo nthawi zambiri sichitha kupha moyo. Izi zanena kuti, nthawi zambiri zimasokoneza khalidwe la moyo.
Kwa choyamba chokumana nacho ndi ululu wammbuyo, kufufuza ndi dokotala wanu mwina ndi lingaliro labwino.
Sindikirani yemwe dokotala wabwino kwambiri yemwe amamupitako ndi. Iye adzakufunsani mafunso ena ofunika monga njira yowonjezera zizindikiro zanu mpaka kugwiritsidwa ntchito.
Mafunso awa angaphatikizepo: Kodi mukuchita chiyani pamene ululu unayamba? Kodi ululuwo unabwera pang'onopang'ono kapena mwadzidzidzi? Kodi umamva kuti ululu uli kuti?
Kodi zimamva bwanji? Mau angapo pofotokoza zizindikiro zanu zilipo, kotero mukhale nawo. Mutha kumverera zizindikiro zamagetsi monga mapini ndi singano, kuyaka, mantha, ndi zina zotero, kapena mungakhale ndi thupi lopweteka. Mukamatha kufotokozera bwino momwe mukukumvera, zimakhala zabwino. Kulongosola kwanu kumapereka dokotala chinachake choti apitirize popanga matenda ndi zotsatira zothandizira mankhwala.
Zina zomwe dokotala wanu angafunike kudziwa ndi nthawi ya ululu. Mwa kuyankhula kwina, ndi liti pamene ilo limabwera ndipo liti lithetsedwa, zomwe iwe umachita mwakuthupi, ndi zina.
Mayeso Odziŵa-Kodi Mukuwafuna?
Madokotala ambiri ali ndi chizoloŵezi chokonzekera kuti odwala awo azivutika kwambiri ndi ululu kapena ululu wammbuyo. Izi zingaphatikizepo X-ray, MRI, komanso mayesero a magazi .
Mayeserowa sikuti nthawi zonse amafunikira. American College of Radiology imanena kuti kupweteka kwapweteka kosautsika kopanda phokoso kapena popanda radiculopathy ndi khalidwe loipa (ndi kudziletsa) ndipo motere silingalole kuyerekezera kuyezetsa magazi.
Mwachitsanzo, ngati muli ndi "ziphuphu zofiira" monga ululu wosasunthika usiku, kupweteka komwe kuli kovuta m'mawa koma kumakhala bwino ngati tsiku likupita, kapena ululu umene umatha kwa nthawi yaitali kuposa sabata, dokotala wanu angaganize kuti ululu wanu ndi chifukwa cha matenda osokoneza bongo.
Mofananamo, ngati muli ndi matenda odwala matenda a mitsempha, muli ndi vuto linalake, kapena mutagwiritsira ntchito steroids kwa nthawi yaitali, mafilimu angakhale othandiza pakufufuza.
Phunziro la 2016 la German lomwe linafalitsidwa mu nyuzipepala ya Deutsche medizinische Wochenschrift inapeza kuti ngakhale 10 peresenti ya odwala kupweteka kumbuyo amapeza mafilimu opatsirana, mpaka gawo limodzi mwa magawo atatu a zovutazi sizingakhale zofunikira.
Kodi Dokotala Wanga Adzafotokozera Mavuto Opweteka?
Madokotala ambiri amapereka mankhwala opweteka kwa odwala oyamba omwe abwerera. Mitundu iliyonse ya mankhwala opweteka imabwera ndi zotsatira zake, koma posachedwa FDA inasintha maonekedwe a Advil (ibuprofen).
Kafukufuku omwe adawawonetsa amasonyeza kuti ngakhale masabata angapo ogwiritsira ntchito angathe kuwonetsa chiopsezo chachikulu cha matenda aakulu monga matenda a mtima.
Chomvetsa chisoni n'chakuti madokotala ambiri amapereka ululu wa mankhwala osokoneza bongo amatsitsa pamimba, ngakhale kwa odwala omwe ali ndi zowawa, zowawa. Lingaliro langa ndilokuti ochita opaleshoniwa akusokoneza kwambiri anthuwa chifukwa cha chiopsezo chowonjezereka chokhala ndi chizoloŵezi chotengera mankhwala osokoneza bongo.
Kuwongolera mwatsatanetsatane mu magazini ya May 2016 a Journal of the American Medical Association anapeza kuti ngakhale kuthekera kwa opioid analgesics kuthetsa kupweteka kwapweteka kosautsa sikudziwika, palibe umboni wa zotsatira zothandiza pa zowawa zopanda malire zam'mbuyo zosachepera . Chimodzi mwa zifukwa zawo zazikulu kuti opioid ikhoza kupereka mpumulo waifupi, koma ndizo zokhudzana ndi izi.
Kodi mungatani kuti muthe kufufuza zomwe JAMA anapeza pa opioids za kupweteka kwapweteka kwa nthawi yaitali (ngati muli ndi vuto limodzi)? Mungaganizire izi pangozi kuti mupindule pangodya. Kugwiritsa ntchito mankhwala osokoneza bongo chifukwa cha kupwetekedwa kwapweteka kwapweteka kungatanthauzenso kuti mungasokonezedwe chifukwa cha kupumula kwapang'ono pomwe.
Poyamba, zingawoneke ngati mukusowa chilichonse chimene mungapeze kuti muthane ndi zomwe mukukumana nazo, koma muli ndi njira zina. Monga tafotokozera pamwambapa, pali mitundu yosiyanasiyana ya ululu wopatsirana monga si-steroidal anti-inflammatories (yomwe ibuprofen ndi imodzi) ndi Tylenol (acetaminophen). Mwa kuyankhula kwina, si mankhwala onse opweteka omwe ndi nthano mu chilengedwe. Ndipo njira zopanda kupweteka za mankhwala monga kuchitidwa thupi, kuchita masewera olimbitsa thupi , kapena kusinkhasinkha zingakhale zothandiza kwambiri.
Osati kokha, ndizotheka kuti opioids amatha kupha, kupereka mphamvu zambiri kuposa zomwe zimafunikira kuti asamve ululu woyang'anira nthawi yoyamba yochiritsa.
Kawirikawiri, palibe njira yothetsera ululu wammbuyo ndiyo yothetsera zonse. M'malomwake, AHRQ imatiuza kuti munthu aliyense amatha kupeza chithandizo chamtundu wafupipafupi. Njira yabwino, ndipo imodzi yomwe amagwiritsidwa ntchito ndi akatswiri ambiri, ndi kuphatikiza mankhwala ochepetsetsa ang'onoang'ono komanso ochepa kuti agwirizane.
AHRQ imaphatikizapo kuti nthawi zambiri, zotsatira zabwino za mankhwala opweteka kumbuyo zimatha kukhala panthaŵi yochepa chabe. Amanenanso kuti mankhwalawa amathandiza bwino kupweteka kusiyana ndi kubwezeretsa ntchito yanu. Pachifukwa ichi kutenga njira yogwira-popanda kuchita-ingakhale njira yabwino kwambiri yosungira ululu panthawi yomwe mukupita patsogolo m'moyo.
Zotsatira :
AHRQ. Matenda Osapulumutsidwa Ovutika Kwambiri. Bungwe la Healthcare Research ndi Quality webusaiti. Feb. 2016. Kufikira: June 2016. http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=2192
Linder R, Horenkamp-Sonntag D., Engel S., Schneider U., Verheyen F. Kulimbikitsidwa kwabwino pogwiritsira ntchito deta nthawi zonse Dtsch Med Wochenschr. May 2016. Kupezeka: June 2016. http://www.ncbi.nlm.nih.gov/pubmed/27176071
Patel ND, Broderick DF, Burns J, Deshmukh TK, Fries IB, Harvey HB, Holly L, Womenyera CH, Jagadeesan BD, Kennedy TA, O'Toole JE, Perlmutter JS, Policeni B, Rosenow JM, Whitehead MT, Cornelius RS, Corey AS, Gulu la Akatswiri pa Kujambula kwa Neurologic. ACR Appropriateness Criteria® yopweteka kwambiri. Reston (VA): American College of Radiology (ACR); 2015. 12 p. [Mavesi 30]
Shaheed C, Maher C, Williams K, ndi al. Mphamvu, Kusamalidwa, ndi Dose-Zotsatira Zomwe Zimadalira Opioid Analgesics kwa Low Back Pain. JAMA Internal Medicine . May 2016. Kupezeka: June 2016. http://archinte.jamanetwork.com/article.aspx?articleid=2522397
Volkow N, McLellan T. Opioid Abuse in Chronic Pain - Maganizo Olakwika ndi Kuletsa Mikhalidwe. N Engl J Med. 2016. http://www.nejm.org/doi/full/10.1056/NEJMra1507771#t=article